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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Wed Jan 28 2026
Journal Name
Al-fatih Journal
Some cognitive sense of kinesthetic and spatial relationship to the level of learning some skills in the ground dictated by hardwareResearch and descriptiveStudents on the third phase of the Faculty of Physical Education for Girls - University of Baghdad
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إن النجاح في أداء المتطلبات الفنية والخططية في أي من الألعاب ألرياضيه يستوجب امتلاك العناصر الاساسيه المتعلقة بطبيعة الاداء ونوع الفعالية الرياضية الممارسة , لذا فان اغلب الألعاب الرياضية تعتمد على مكونات ألقدره التوافقيه والادراكيه الحسيه بوصفها احد العناصر الاساسيه في المستويات العليا لما توفره من قاعدة اقتران للصفات البدنيه والحر كيه وقدرات أجهزة الجسم الوظيفية , وفقا للأسس المعتمدة في بناء مهاراته, وع

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Haughtiness and the Humility in Al Koran
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Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of

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Publication Date
Fri May 17 2019
Journal Name
Biochem. Cell.arch
THE EFFICACY OF GOLD NANOPARTICLES IN INHIBITING THE TOXICEFFECT OF TAMOXIFEN ON THE KIDNEYS OF MALE ALBINO MICE
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Publication Date
Wed Jan 28 2026
Journal Name
The Iraqi Journal For Information And Documentation Studies
The role of performance indicators in evaluating the performance of the University of Technology&#39;s Central Library
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University libraries seek to evaluate their performance in order to correct their path and adjust it in the right direction. Therefore, they use (performance indicators), which are a tool used by institutions to evaluate the weaknesses and strengths in their work and the reasons for failure to achieve some goals sometimes. They convert (goals, procedures and actions) into a formula that can be measured mathematically, which contributes to the library determining the gap between its current performance and what those libraries are supposed to be on, clarifying the path that the library is following, controlling the risks that may befall it, and thus enhancing the process of continuous improvement to avoid areas of failure and weakness becaus

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the theoretical framework of the REA accounting model Used in the design of accounting information systems
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Researchers often equate database accounting models in general and the Resources-Events-Agents (REA) accounting model in particular with events accounting as proposed by Sorter (1969). In fact, REA accounting, database accounting, and events accounting are very different. Because REA accounting has become a popular topic in AIS research, it is important to agree on exactly what is meant by certain ideas, both in concept and in historical origin. This article clarifies the analyzing framework of REA accounting model and highlights the differences between the terms events accounting, database accounting, semantically-modeled accounting, and REA accounting. It als

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Test the Efficiency of some Plants in the Tolerant of Air Pollution within the City of Baghdad. Iraq
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This study was designed to monitor the ambient air pollution in several sites within Baghdad City of Iraq. The readings started from May 2016 to April 2017. The highest concentration of sulfur dioxide (SO2) was 2.28 ppmm-3 while nitrogen dioxide (NO2) was 3.68 ppmm-3 and suspended particulate matter was 585.1 ?gm-3. This study also included estimating the value of the air pollution tolerance index (APTI) for four plant's species Olea europaea L., Ziziphus spina-Christi (L.) Desf, Albizia lebbeck(L.) Benth. and Eucalyptus camaldulensis Dehnh. Were cultivated on the road sides. The study includes four biochemical parameters, total chlorophyll content, ascorbic acid content, pH and relative water content of plant leaves. The results show that

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Publication Date
Wed Jul 01 2020
Journal Name
Plant Archive
A comparative taxonomic study of seeds of some plants of rosaceae family in Iraq
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Publication Date
Wed Jan 28 2026
Journal Name
Modern Sport
Design and standardization of two scoring tests for the initial selection of people with simple mental disabilities in five-a- Side Soccer
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The five-a- Side Soccer for simple mental disability is as interesting and caring as many other sporting events. Therefore, the researchers believe that their basic skills tests are compatible with then level of the tested individuals in terms of age and mental ability. As a means of selecting those who are qualified to practice this game in a simple way, the problem of research has been identified in the design and standardization of two scoring skills that belong to this category and are approved by the training staff during the initial selection process. The research community is determined by people with mental disabilities who belong to the governmental and private institutes and the Special Olympics Union in Baghdad and for the year 2

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Marketing commission and its role in enhancing the competitive advantage of insurance companies : Applied research on a sample of Iraqi insurance companies
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Abstract:

                 The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private

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Publication Date
Fri Mar 13 2020
Journal Name
Sustainability
Consumers’ Perceptions and Attitudes toward Products Preventing Microfiber Pollution in Aquatic Environments as a Result of the Domestic Washing of Synthetic Clothes
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Microfibers released by synthetic clothes have a significant negative effect on the environment. Several solutions have been proposed and evaluated for their effectiveness, but studies have failed to address the human-centered aspects of these products. In this research, the possibilities and needs from a consumer perspective for a new filtering system for domestic washing machines were examined. First, a quantitative (questionnaire) and a qualitative (interviews and observations) exploration were done to understand the desired requirements from a user perspective. Next, the acceptance of various existing solutions for microfiber catching was investigated. To verify these requirements, a new concept was designed and evaluated with a

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